Photodynamic diagnostic ureteroscopy using the VISERA ELITE video system for diagnosis of upper-urinary tract urothelial carcinoma: a prospective cohort pilot study.
5-Aminolevulinic acid
ALA-PDD
Photodynamic diagnosis
Upper urinary tract urothelial carcinoma
VISERA ELITE video system
Journal
BMC urology
ISSN: 1471-2490
Titre abrégé: BMC Urol
Pays: England
ID NLM: 100968571
Informations de publication
Date de publication:
25 Mar 2021
25 Mar 2021
Historique:
received:
08
01
2021
accepted:
15
03
2021
entrez:
26
3
2021
pubmed:
27
3
2021
medline:
27
8
2021
Statut:
epublish
Résumé
The advantages of photodynamic diagnostic technology using 5-aminolevulinic acid (ALA-PDD) have been established. The aim of this prospective cohort study was to evaluate the usefulness of ALA-PDD to diagnose upper tract urothelial carcinoma (UT-UC) using the Olympus VISERA ELITE video system. We carried out a prospective, interventional, non-randomized, non-contrast and open label cohort pilot study that involved patients who underwent ureterorenoscopy (URS) to detect UT-UC. 5-aminolevulinic acid hydrochloride was orally administered before URS. The observational results and pathological diagnosis with ALA-PDD and traditional white light methods were compared, and the proportion of positive subjects and specimens were calculated. A total of 20 patients were enrolled and one patient who had multiple bladder tumors did not undergo URS. Fifteen of 19 patients were pathologically diagnosed with UT-UC and of these 11 (73.3%) were ALA-PDD positive. Fourteen of 19 patients were ALA-PDD positive and of these 11 were pathologically diagnosed with UC. For the 92 biopsy specimens that were malignant or benign, the sensitivity for both traditional white light observation and ALA-PDD was the same at 62.5%, whereas the specificities were 73.1% and 67.3%, respectively. Of the 38 specimens that were randomly biopsied without any abnormality under examination by both white light and ALA-PDD, 11 specimens (28.9%) from 5 patients were diagnosed with high grade UC. In contrast, four specimens from 4 patients, which were negative in traditional white light observation but positive in ALA-PDD, were diagnosed with carcinoma in situ (CIS). Our results suggest that ALA-PDD using VISERA ELITE is not sufficiently applicable for UT-UC. Nevertheless, it might be better particularly for CIS than white light and superior results would be obtained using VISERA ELITE II video system. The present clinical study was approved by the Okayama University Institutional Review Board prior to study initiation (Application no.: RIN 1803-002) and was registered with the UMIN Clinical Trials Registry (UMIN-CTR), Japan (Accession no.: UMIN000031205).
Sections du résumé
BACKGROUND
BACKGROUND
The advantages of photodynamic diagnostic technology using 5-aminolevulinic acid (ALA-PDD) have been established. The aim of this prospective cohort study was to evaluate the usefulness of ALA-PDD to diagnose upper tract urothelial carcinoma (UT-UC) using the Olympus VISERA ELITE video system.
METHODS
METHODS
We carried out a prospective, interventional, non-randomized, non-contrast and open label cohort pilot study that involved patients who underwent ureterorenoscopy (URS) to detect UT-UC. 5-aminolevulinic acid hydrochloride was orally administered before URS. The observational results and pathological diagnosis with ALA-PDD and traditional white light methods were compared, and the proportion of positive subjects and specimens were calculated.
RESULTS
RESULTS
A total of 20 patients were enrolled and one patient who had multiple bladder tumors did not undergo URS. Fifteen of 19 patients were pathologically diagnosed with UT-UC and of these 11 (73.3%) were ALA-PDD positive. Fourteen of 19 patients were ALA-PDD positive and of these 11 were pathologically diagnosed with UC. For the 92 biopsy specimens that were malignant or benign, the sensitivity for both traditional white light observation and ALA-PDD was the same at 62.5%, whereas the specificities were 73.1% and 67.3%, respectively. Of the 38 specimens that were randomly biopsied without any abnormality under examination by both white light and ALA-PDD, 11 specimens (28.9%) from 5 patients were diagnosed with high grade UC. In contrast, four specimens from 4 patients, which were negative in traditional white light observation but positive in ALA-PDD, were diagnosed with carcinoma in situ (CIS).
CONCLUSIONS
CONCLUSIONS
Our results suggest that ALA-PDD using VISERA ELITE is not sufficiently applicable for UT-UC. Nevertheless, it might be better particularly for CIS than white light and superior results would be obtained using VISERA ELITE II video system.
TRIAL REGISTRATION
BACKGROUND
The present clinical study was approved by the Okayama University Institutional Review Board prior to study initiation (Application no.: RIN 1803-002) and was registered with the UMIN Clinical Trials Registry (UMIN-CTR), Japan (Accession no.: UMIN000031205).
Identifiants
pubmed: 33765999
doi: 10.1186/s12894-021-00819-2
pii: 10.1186/s12894-021-00819-2
pmc: PMC7995577
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
45Références
World J Nephrol. 2016 Mar 6;5(2):158-65
pubmed: 26981440
World J Urol. 2017 Mar;35(3):379-387
pubmed: 27604375
PLoS One. 2012;7(6):e36729
pubmed: 22715360
Arab J Urol. 2017 Mar 06;15(2):100-109
pubmed: 29071138
Jpn J Clin Oncol. 2010 Nov;40(11):1087-91
pubmed: 20581003
Acta Med Okayama. 2017 Jun;71(3):227-232
pubmed: 28655942
Photodiagnosis Photodyn Ther. 2013 Feb;10(1):39-41
pubmed: 23465371
Arab J Urol. 2012 Jun;10(2):138-42
pubmed: 26558016
Photodiagnosis Photodyn Ther. 2010 Mar;7(1):39-43
pubmed: 20230992
Urol Int. 2014;93(4):384-8
pubmed: 25059717
Int J Urol. 2018 Aug;25(8):723-729
pubmed: 29999205
Photodiagnosis Photodyn Ther. 2016 Mar;13:255-260
pubmed: 26256824
Cancer. 2011 Mar 1;117(5):938-47
pubmed: 21351082
BJU Int. 2012 Feb;109(4):608-13; discussion 613-4
pubmed: 21985291
BJU Int. 2012 Dec;110(11 Pt B):E596-600
pubmed: 22758907
Expert Rev Anticancer Ther. 2017 Jun;17(6):545-554
pubmed: 28480774
Photodiagnosis Photodyn Ther. 2013 May;10(2):127-33
pubmed: 23769278
J Urol. 1998 Feb;159(2):401-4
pubmed: 9649248
Photodiagnosis Photodyn Ther. 2015 Jun;12(2):193-200
pubmed: 25843912
BMJ Open. 2019 Sep 3;9(9):e022268
pubmed: 31481549
Eur J Clin Invest. 1992 Jun;22(6):407-11
pubmed: 1633836
BJU Int. 2013 Dec;112(8):1096-104
pubmed: 24053153
Biomed Res Int. 2015;2015:547586
pubmed: 25654112